Pressure sensor disconnect detection for a blood treatment device

ABSTRACT

A system is disclosed for detecting an electrical sensor, the system includes a sensor signal processing circuit further comprising an input port to receive a connector including the output signal lines of the sensor, a resistor connected to the output signal line of said input port, wherein the resistor is connected to a predetermined voltage; a sensor circuit having a connector adapted to connect to the connector, wherein the sensor circuit has a resistance substantially less than the pull-resistor, and the sensor signal processing circuit detects an unconnected sensor based on the voltage applied by the resistor.

BACKGROUND OF THE INVENTION

This invention relates to the medical instruments for extracorporealtreatment of blood and user interfaces for such instruments. Oneembodiment of the invention relates to a user interface for medicalinstruments for Renal Replacement Therapy and Artificial Kidneytherapies.

1. Renal Replacement Therapies

Renal Replacement Therapy (RRT) can be performed in specialized dialysiscenters for treatment of chronic patients that have permanently lostkidney function and in hospitals for treatment of patients with a needfor temporary replacement of renal function. Different modalities ofContinuous Renal Replacement Therapy (CRRT) have been used to treatpatients suffering from excess fluid overload and acute renal failure.In acute settings, CRRT has been performed using standard methods ofhemodialysis and continuous arterio-venous hemofiltration (CAVH). Morerecently, continuous veno-venous hemofiltration (CVVH) has been used toreduce the complications associated with such issues as hemodynamicinstability and need for arterial access. Regardless of the type ofmedical equipment used and the specific type of treatment performed, RRTrequires establishing an extracorporeal blood circulation path thatpasses blood through a filtration device.

RRT performs two primary blood treatment functions: ultrafiltration(removal of water from blood plasma), and solute clearance (removal ofdifferent molecular weight substances from blood plasma). RRT involvesthe use of a filter in a blood circuit through which circulatesextracorporeal blood temporarily withdrawn from a patient. The RRTfilter, also called hemofilter or dialyzer, can be set up to performeither or both of these functions simultaneously, with or without fluidreplacement, accounting for the various modes of renal replacementtherapy. “Clearance” is a term that describes the removal of substances,both normal and waste product, from blood.

Ultrafiltration is the convective transfer of fluid out of a plasmacompartment of a filter and through pores in the filter membrane. Thepores of the filter membrane pass (filter) water, electrolytes and smalland middle-sized molecules (up to 20,000 to 30,000 daltons) from theblood plasma. Large molecules, proteins blood cells and otherlarge-sized plasma components (as well as a portion of the water andsmaller components) do not pass through the filter membrane and remainin the plasma compartment of the blood circuit and are returned to thepatient. The ultrafiltrate output (e.g., water extracted from the blood)from the filtration pores is similar to plasma, but without the plasmaproteins or cellular components. Since the concentration of smallsolutes is the same in the ultrafiltrate as in the plasma, no clearanceis obtained from the plasma, but fluid volume, e.g., water, is removed.

Dialysis is the diffusive transfer of small solutes out of a bloodplasma compartment of a filter by diffusion across the filter membrane.This transfer occurs as a result of a concentration gradient, withdiffusion occurring from the filter compartment with higherconcentration (typically the blood compartment) to the filtercompartment with lower concentration (typically the dialysatecompartment). Since the concentration of solutes in the plasmadecreases, clearance is obtained, but fluid may not be removed indialysis. Ultrafiltration can be combined with dialysis to obtain bothclearance and fluid removal from blood plasma.

Hemofiltration is the combination of ultrafiltration and fluidreplacement in the treatment of blood. Typically, hemofiltrationtreating larger volumes of blood than is needed for fluid control. Thereplacement fluid contains electrolytes, but not other small molecules.Since the net effect of replacing fluid without small solutes andultrafiltration of fluid with small solutes results in net removal ofsmall solutes, clearance is obtained during hemofiltration.

2. Limitations of User Interface of Existing Devices for RRT

RRT devices use sets of disposable blood passage circuits (generallyreferred to as “disposables”) generally including tubing, filters,catheters, sensors and connectors that form a fluid circuit and are indirect contact with the blood and the fluid removed from the blood.These disposables can be assembled from components made by variousmanufacturers. Some more expensive disposables such as dialyzers can beused several times to treat the same patient. In some cases, disposablesets come assembled and the user need only mount the disposable bloodpassage on an instrument and pumping machine, and then prime the bloodpassage with sterile saline solution prior to its use. When the RRTdevice is ready for use, it is connected to the network of disposableand fluid filled tubes and electronic sensors that include thedisposable blood passageway.

Modem RRT devices are microprocessor controlled. The microprocessoroperates pumps, reads sensors and communicates with the user via a userinterface regarding the RRT treatment. In more advanced RRT devices, theuser interface has a graphics display that may be a touch screen or havean associated keypad. By interacting with a display and keys, the userinterface enables a user to control the RRT device and monitor itsoperation.

During the operation, the RRT device detects conditions that triggeralarms and require user intervention. These alarms may occur often. Forexample, joints between parts in the blood passage disposable can springleaks, allowing the ingress of air and facilitating clotting. Clottingof blood often occludes the blood passages. These RRT devicesincorporate pressure sensors that enable them to detect disconnectionand occlusion of tubing and components of the blood circuit. Air andblood leak detectors are also used to detect other alarm conditions thatrequire immediate action from the user.

To operate RRT devices, a high degree of skill is required from users totroubleshoot the causes of alarms and promptly rectify the conditionthat provoked the alarm. A quick response from the user is neededbecause the RRT device is usually stopped as a result of the alarm, andwithin minutes the blood in the circuit may coagulate. Generally, whenan alarm condition occurs, a user will receive an alarm notification andan alarm code from the RRT device. For example, code “E001” may bedisplayed on a numeric display. The user will interpret this as an alarmcode by remembering that “E001” is a particular alarm or by consulting amanual for the RRT device that defines the display codes for the device.In the latest generation of RRT machines, less cryptic text messages arepresented that describe alarm conditions. Instead of flashing an alarmcode E001, for example, the RRT device displays a message such as“Infusion Tubing Disconnected”. This plain language alarm messagemethodology is effective, but is still not intuitive to less-trainedoperators of the RRT device. Also, in the global marketplace, confusionoften results from a language barrier and non-English speaking operatorshave difficulty with English language messages.

U.S. Pat. No. 5,858,239 discloses a dialysis machine that has a graphicsdisplay where a user is assisted by simple pictograms similar to “icons”used by the commonly used Microsoft Windows™ personal computer operatingsystem. Another user interface that makes use of graphical icons insteadof or complimenting text messages is disclosed in U.S. Pat. No.5,620,608 for a dialysis machine. Although these icons help a user of adialysis device navigate through a menu system, they are not helpful introubleshooting faults in the blood fluid path of the device. A graphicsuser interface for an aphaeresis blood processing apparatus usingpictorials is disclosed in U.S. Pat. No. 5,653,887, which displays iconsand a symbolic diagram of the apparatus with an arrow pointing towardsan element (blood centrifuge) requiring user attention. However, thegraphics user interfaces disclosed in the prior art lack the ability toclearly direct a user to the specific point in the blood fluid pathwhere an occlusion has been detected or the blood flow continuity hasbeen broken.

SUMMARY OF THE INVENTION

A new and improved graphical user interface (GUI) for a RRT machine hasbeen developed that integrates pictograms that point the user to theexact location of a fault in the machine blood circuit or fluid path.

The GUI addresses the needs of fluid removal and dialysis users byproviding an intuitive interface that includes a dynamic pictorialdiagram of the RRT device. The diagram shows the device in outline form,and emphasizes the fluid path, e.g., series of disposable componentsthrough which various fluids flow during treatment. In RRT devices thesefluids include the pathway for the patient's blood, and can additionallyinclude fluid paths for ultrafiltrate, dialysate and replacementsolution.

The GUI as disclosed here is directed to an RRT device, but can be usedin assisting any treatment that involves extracorporeal circulation.Extracorporeal blood circulation involves the continuous withdrawal ofblood from a patient, where the blood is processed outside of thepatient and then returned to the patient. Examples of such treatmentsare blood aphaeresis, heart-lung machines, full or partial heart bypassand transfusion of blood.

The pictorial diagram of the fluid path on the GUI display is designedto primarily assist the operator of an RRT device in identifying thesource of an alarm caused by a malfunction of the circuit. The GUIdisplay also may be used to assist the operator in assembling thedisposable blood circuit, mounting it on the RRT pumping device,threading the tubing of the circuit into roller pumps, and connectingsensors and de-bubbling components of blood passage to the RRT device.

The pictorial aid of the GUI shows various interconnected tubes, valves,pumps and sensors of the disposable extracorporeal circuit. Tube linesof different color can identify different fluids. For example,bloodlines made be red on the display, and dialysate lines yellow.During normal operation of the device, only the lines actively involvedin a particular treatment will be displayed. For example, if a dialysatesolution is not involved in a treatment (such as hemofiltration), thecorresponding dialysate fluid lines will not be displayed. The directionof fluid flow may be indicated by arrows or by an animation of thedisplayed pictogram. The pump rotation and fluid motion can be animatedon the display as can be the level of fluid in different reservoirs suchas dialysate, replacement solution or effluent collection bags.

If a fault is detected by the RRT device at a particular point along thefluid path, the corresponding position of the fluid path as shown on thepictogram will be accentuated. The location of the fault can be aparticular bloodline segment, a pump, a reservoir, a connector or asensor. A sensor can be, for example, a pressure sensor, an airdetector, a weight scale or a blood leak detector. The fluid pathelement that needs attention from user can be identified on the displayby a change of color, flashing of a specific portion of the diagram orby changing shape of the displayed element. In addition, an arrow on thedisplay can point to the element shown in the pictogram. Typically amessage is displayed elsewhere on the graphics screen instructing theuser how to rectify the problem. The pictogram is immediately responsiveto user actions. For example, if a disconnected sensor symbol is beingflashed to attract the user's attention, and the user re-connects it,the pictogram will immediately change to its normal state.

Another aspect of the proposed method is that it assists the operator indetecting tubes that are not properly inserted into sensor elements ofthe RRT device console. Voltage outputs from sensors, such as aphotometric blood leak detector and an ultrasonic air detector, can beused to detect fluid tubes that are not properly inserted into thesensor or other components of the RRT device. The user attention of theoperator will be attracted by the flashing element of the pictogram sothat user could insert the tube into the sensor tubing receptacle. Thepictorial element will immediately stop flashing if the condition iscorrected.

BRIEF DESCRIPTION OF THE DRAWINGS

A preferred embodiment and best mode of the invention is illustrated inthe attached drawings that are described as follows:

FIG. 1 is a perspective view of an intravenous blood ultrafiltrationsystem using a disposable blood circuit and a user interface.

FIG. 2 is a schematic diagram showing a fluid path of blood and removedfluids for the blood circuit used with the ultrafiltration system shownin FIG. 1.

FIG. 3 is an enlarged view of the user interface area of the deviceshown in FIG. 1 with a graphics screen.

FIG. 4 is a schematic diagram of the LCD Screen layout.

FIGS. 5 and 6 are examples of screens with pictograms indicating airdetection and infusion disconnection faults.

FIGS. 7 and 8 show two further sample screens of the LCD 127. Pictogram601 shows a system with a detected blood leak into the ultrafiltrateline. This failure of the circuit is detected by the photometric bloodleak detector. Because blood is detected in the ultrafiltrate line, theblood leak detector 602 on the pictogram is flashing. In addition,pictogram 603 shows the system has detected an occlusion in the bloodinfusion tubing between the blood pump and the return cannula in thevein in the patient's arm. The return bloodline 604 is flashing.Similarly, the pictogram may flash in alternating colors the infusion orwithdrawal tubing to designate a location of a bloodline, where aleakage or occlusion of blood has been detected based on an analysis bythe controller of pressure between the filter and infusion catheter orthe filter and withdrawal catheter.

FIGS. 9 and 10 are examples of screens with pictograms indicatingultrafiltrate sensor failure and withdrawal bloodline disconnectionfaults.

FIGS. 11 and 12 show a pictogram 801 of the system that detected adisconnection in the ultrafiltrate withdrawal line 802. A side view ofthe pump console is shown and the ultrafiltrate line is highlighted.Pictograph 803 of the system shows that there is a detected a jammedrotor of the blood pump 804. The pump element of the pictogram ishighlighted and flashing are examples of screens with pictogramsindicating disconnection of an ultrafiltrate line and jammed blood pumpfaults.

FIGS. 13 and 14 are examples of screens with pictograms indicatingwithdrawal bloodline occlusion and ultrafiltrate weight mismatch faults.

FIGS. 15 and 16 are examples of screens with pictograms indicatingwithdrawal pressure sensor and ultrafiltrate line occlusion faults.

FIGS. 17 and 18 illustrate the electrical architecture of theultrafiltration controller system.

DESCRIPTION OF AN EMBODIMENT OF THE INVENTION

The preferred embodiment of the present invention is a Graphical UserInterface (GUI) that is a part of a blood ultrafiltration system and isused with a single use disposable set for ultrafiltration of blood totreat fluid overload in patients in a hospital setting. The disposableultrafiltration set and the system are disclosed in commonly-owned U.S.patent application Ser. No. 09/660,195 filed on Sep. 12, 2000 and U.S.patent application Ser. No. 09/696,642 filed on Oct. 26, 2000, whichapplications are incorporated herein by reference.

To remove excess fluid from the patient the ultrafiltration set ismountable on a system console that is equipped with two pumps. One pumpmoves and controls the flow rate of blood through the tubing and filterof the ultrafiltration set. The other pump moves and controls the flowrate of ultrafiltrate. The ultrafiltration set contains a disposableblood/ultrafiltrate fluids circuit with an integral blood separationfilter and three integrated pressure sensors. When the set is assembledon the system and is connected to the patient, the set forms a fluidspath for blood and ultrafiltrate. The system interfaces with the fluidpath via sensors and pumps. The Graphical User Interface or GUI is anintegral part of the system console. It is used to give the operatorinformation about treatment and assist them in identifying faults in thefluid path and causes of alarms.

FIG. 1 shows an intravenous blood ultrafiltration system 100 fortreating a patient (not shown) suffering from fluid overload. The systemconsole 128 has a front panel with a membrane keypad 125 and a graphicsdisplay 127. To initiate ultrafiltration treatment, two plasticintravenous cannulae or needles are introduced into suitable peripheralveins of the patient for the withdrawal and return of the blood. Theneedles are attached to withdrawal tubing 104 and return tubing 105, andsecured to skin with attachments, such as adhesive strips. Thewithdrawal and return tubing, 104 and 105, forms portions of acontinuous blood fluid passage 108 that extends through a disposableblood circuit 109 (FIG. 2). The disposable blood circuit cartridge 109is attached to a pumping system 110 to perform treatment.

Tubing sections of the blood circuit extend through cartridge 109, andform additional conduit links in the blood fluid passage 108. Thesetubing links are coupled to a blood filter 111 and blood pressuresensors 112, 113, that are contiguous with the tubing and form sectionsof the blood fluid passage 108. In other embodiments, the blood filter111 may be supplied separately from other components of the bloodcircuit, and then the filter is connected to the blood circuit cartridgeby the operator before treatment.

The disposable blood ultrafiltration circuit cartridge may be suppliedseparate from the system, and packaged in a sterile package. The circuitis generally intended to be used for one single RRT treatment and is notreused. The cartridge is inserted into the pump system 110 by threadingthe tubing loops 121 in the blood passage 108, and ultrafiltratedischarge tubing 119 over the rims of roller pumps 122 and 126,respectively. As pumps 122 and 126 rotate, they slidably engage thetubing and force blood and ultrafiltrate fluids to move through thecartridge fluid passages. Microprocessor pump drivers control rotationalspeed of the pump and, thus, control the flow rate of the blood andultrafiltrate through the fluid path. The pump drivers are part ofsystem 110 and are controlled by a microprocessor controller within pumpsystem 110 (FIG. 17).

The tubing of the blood circuit cartridge 109 may be mounted in amolded-plastic housing 123 that fits into a recess in the surface ofsystem 110 and snaps into system 110 with latches 124. A bloodwithdrawal pressure sensor 112 is mounted to an inside surface of thecartridge housing 123. A pressure sensor 113 for the blood return tube105 and an ultrafiltrate pressure sensor 114 are mounted to an insidesurface of the second cartridge housing 129. Blood pressure sensors 112and 113 and ultrafiltrate pressure sensor 114 include transducers thatconvert pressures into electrical signals carried by signal wires 131that are connected to microprocessor controller in system 110 via theplug-in connectors 218, 219 and 220. Sensors 112, 113 and 114 may bemodel MPX2300 sensors manufactured by Motorola. Filter 111 in the may bea hemofilter having a polysulfone hollow fiber membrane available fromMinntech of Minnesota.

The system console 128 has a front side having the display 127, keypad125 and first roller pump 122. The console 128 also has a side,orthogonal to the front, which has the second roller pump 126. The bloodcircuit cartridge 109 is mounted on the console 128 by wrapping theblood circuit cartridge around the front and side of the console.Specifically, the tubing for the bloodline in the cartridge is insertedon the first roller pump 122. The filter 111 and tubing for the secondroller pump 126 is attached to and mounted on the side of the console.By using both the front and side of the console to mount the bloodcartridge, the front area of the console is substantially reduced. Inparticular, by folding the blood circuit around the front and side ofthe console, the area needed on the front face of the console to supportthe blood circuit is effectively reduced by one-half. Thus, the consolecan have a smaller front side and have a more compact and appealingappearance.

FIG. 2 is a schematic diagram of the blood and filtrate flow through theultrafiltration system 100 known as a system flow path. The systemsymbolically depicted in the FIG. 2 is designed primarily to performSCUF (Slow Continuous Ultrafiltration) but can be easily converted forother RRT treatment modalities. The port 153 of the hemofilter 111 isplugged for SCUF. If dialysis is desired, a source of dialysate fluidcan be connected to this port 153. Dialysis fluid will circulate throughthe filter casing and interface with blood through the hollow fibermembrane so that clearance can be obtained via the diffusion of solute.For a dialysis mode, dialysate may circulate in a direction opposite toblood by reversing the pump 126. Alternatively the access port 152 inthe circuit tubing 108 can be used to infuse the replacement solution.Ultrafiltration rate can be increased proportionally by speeding up thepump 122 so that clearance can be obtained by convective transport ofsolute with ultrafiltrate. Similarly, the post-filter port 151 can beused to infuse the replacement solution if desired. With these additions(well known to persons of ordinary skill in the field of RRT), thedescribed apparatus can be used to perform dialysis and hemofiltration.

Regardless of the RRT modality desired, the basic principles of theapparatus design remain the same. Blood that is withdrawn from thepatient flows into the withdrawal tubing 104 and enters the bloodpassage 108 of the blood circuit. Blood passes through the hollow fibersof the filter 111, and is returned to the patient via the return tube105. Ultrafiltrate, effluent or dialysis solution passes through thefilter casing surrounding the blood filled hollow fibers. Prior toreturn, blood passes through the pressure sensor 113. Pump 122 generatesand controls the flow of blood. Pump 126 generates and controls the flowof ultrafiltrate. Pump segment tubing loops 121 are attached tocartridges 123 and 129 to assist loading of pumps and prevent tubes fromkinking. The ultrafiltrate line pressure sensor 114 is integrated intothe same cartridge as the blood return sensor 113. Pressure sensors 112,113 are integral to the blood passage 108 in the cartridges 123 and 129.These sensors are disposed in blood passage 108, such that a diaphragmof the sensor, which is the device that is in fluid contact with theload and directly responds to the blood pressure, is adjacent the bloodpassage.

From the blood pump 122 to the filter 111, blood traverses through anair detector sensor 154. The air detector sensor uses attenuation ofultrasonic sound waves in fluid to detect air bubbles in the bloodpassage 108. An air bubble indicates a leak or break in the bloodcircuit. An air bubble can be dangerous if passed into the bloodstreamof the patient. Accordingly, the detection of an air bubble will causean alarm and stop the pumps.

Similar to the blood pressure sensors in the blood passage of thecircuit, the pressure sensor 114 (which may include a diaphragm in fluidcontact with the filtered fluid) for the ultrafiltrate is integrallyformed in the filtrate tubing 119 of the circuit between the filter 111and the ultrafiltration bag 120. Ultrafiltrate exiting the filter 111passes through the blood leak detector 155. The blood leak detector is aphotometric device that uses infrared light beam to detect presence ofred blood cells in the ultrafiltrate. The detection of blood in theultrafiltrate line indicates a filter failure because blood cells shouldnot normally pass through the filter membrane into the filtrate line.

The blood and ultrafiltrate pressure sensors 112, 113 and 114 areincluded in the disposable cartridge and are intended for one-time use.Air detector 154 and blood leak detector 155 are mounted on the systemconsole and have means to clamp around the plastic tubing that forms thefluid passage. Infrared and ultrasonic waves can penetrate the plastictubing wall.

The sensors each have a generally straight and hollow fluid passage thatis coupled to the blood or filtrate tubing in the cartridge. Thepassages in the sensors are contiguous with the blood and ultrafiltratepassage of the cartridge.

The electrical signal is transmitted by the sensors to the pump system110 through electrical signal lines, e.g., wires. A microprocessorcontroller (FIG. 11) in system 110 receives the pressure signals via thewire lines and determines the pressure level of the blood orultrafiltrate in the fluid passage in which the associated sensor ispositioned. Similarly the system receives information of presence of airin the blood flow or blood in ultrafiltrate.

FIG. 3 illustrates one embodiment of the User Interface for theUltrafiltration system 100. The membrane control panel 125 consists of14 operational keys with 8 non-operational keys for future use. Themembrane panel also displays information to the user regarding, forexample:

-   -   The mode of operation (e.g., STOP, MANUAL, PRIME or RUN) via the        status LEDs on the top left-hand corners of the corresponding        key.    -   The status of the system, ALARM, ALERT or NORMAL via the status        LEDs.    -   Whether ALARM SILENCE is active or not via the alarm silence        LED.    -   The source of power via LED next to the battery and AC plug        symbol.    -   Whether the device is powered ON or OFF.

The ON/OFF key 302 is used to power on the system. The key is in the ONposition when one of the mode keys has an LED (light emitting diodes)are illuminated. A momentary press turns power ON but the key must bedepressed for 0.5 seconds before the device can be powered OFF. When thegreen LED beside the plug symbol is lit it indicates that AC is thesource of power. When the green LED beside the battery symbol is lit itindicates that battery is the source of power.

The STOP key 303 may be used to stop the system and is available in allmodes. When the STOP key is activated, it immediately stops the rotationof the blood and ultrafiltrate pumps and thereby ceases the flow ofblood and filtrate through the blood circuit. Upon power on, the STOPmode is the default mode. The PRIME mode 304 primes the circuit withsaline so as to remove air from the circuit before connecting thecatheters to the patient. In the PRIME mode, the system pumps saline for2 minutes, and then must detect no air in the circuit for 40 seconds(while the saline flows) consecutively before PRIME is deemedsuccessful.

The MANUAL mode 305 replaces the saline in the circuit with blood fromthe patient or to advance an air bubble. The MANUAL mode will beginimmediately from STOP mode when the MANUAL key is pressed. To operatethe system in MANUAL mode, the user has to continually press the MANUALkey. When the MANUAL key is released or a one-minute manual time-outperiod expires, the system will automatically enter the STOP Mode. TheMANUAL key may only be accessed from the STOP mode and only if the PRIMEmode has successfully completed. If the current mode is RUN mode,pressing the MANUAL key has no effect.

The RUN Mode 306 withdraws and infuses blood from and to the patientwhile performing ultrafiltration at the set MAX RATE. Ultrafiltration isperformed when the blood flow exceeds 40 mL/min or some other minimalflow setting. The RUN key may be accessed from the STOP mode after thePRIME mode has successfully completed. The ACCEPT key confirms that theuser intends to enter the PRIME mode or a particular MENU Function.

The CLEAR key 307 clears active alarms, clears the ALARM SILENCEfunction, clears an active request before it has been accepted and movesthe display of selectable functions upwards in the menu level. If thealarm condition is still present, the alarm will re-annunciate after theCLEAR key has been pressed. If the PRIME key is pressed in error in STOPmode (active request), the CLEAR key can be used to clear the requestand return the system to STOP mode. The UP and DOWN arrows 308 allow theuser to scroll through the menu options, scroll help text, and increaseand decrease user settings such as MAX RATE, Alarm Volume and Contrast.The MAX RATE key 309 allows the user to set the ultrafiltrate rate. TheHELP key causes the display of information about the current state ofthe system. If pressed, the HELP key will display the function of thecurrent mode when no alarms are present.

When pressed, the MENU key causes the display to show the followingoptions: Alarm History, Change Date and Time, Change Alarm Volume,Disable Blood Leak Detector, View Software Revision.

The MENU options are available from all modes, STOP, PRIME, MANUAL andRUN.

When selected, the:

-   -   Alarm History option displays the last 10 active alarms along        with the time of occurrence.    -   The Change Date and Time option allows the user to change the        date and time.    -   The Change Alarm Volume allows the user to adjust the main alarm        volume between 65 dBA and 80 dBA.    -   The Disable Blood Leak Detector allows the user to disable the        blood leak detector.    -   The View Software Revision allows the user to see which software        revision the system is running.

The Liquid Crystal Display (LCD) 127 may be a monochrome or color flatpanel display. The LCD screen has a large viewing area, and improves theuser friendliness of the device by providing helpful data to the user onhow to solve each alarm condition.

FIG. 4 illustrates the information displayed on the LCD. The LCD screen127 is divided into five areas. The system state area 401 shows thecurrent system mode and length of time for that mode. The Settings andMonitored Values area 402 show the user set MAX RATE and the actualblood flow in a manner that allows for comparison of these two flowrates. The Alarm and Alert Description area 403 displays the text of theactive alarm. The Pictogram area 404 shows the affected system element,e.g., section of the blood circuit, to the user by flashing thataffected section to draw the user's attention to the source of thealarm. The Alarm Suggestion and system Information area 405 displayssuggested fixes for alarms. It is also used to display help and tonavigate the user through the menu options.

FIGS. 5 and 6 show two sample screens of the LCD screen 127. The airdetector element 501 of the pictogram 500 is flashed to indicate thesource of trouble. The error message 502 is also flashing (changingbackground color). User instructions 503 are displayed to the right ofthe pictogram. Pictogram 505 shows the ultrafiltration console 100 fromthe side. The alarm message 507 indicates that the blood infusion linethat returns blood to the patient is disconnected. The blood return line506 with an arrow at its termination is flashing to indicate to the userthe location of the fault in the circuit.

FIGS. 7 and 8 show two further sample screens of the LCD 127. Pictogram601 shows a system with a detected blood leak into the ultrafiltrateline. This failure of the circuit is detected by the photometric bloodleak detector. Because blood is detected in the ultrafiltrate line, theblood leak detector 602 on the pictogram is flashing. In addition,pictogram 603 shows the system has detected an occlusion in the bloodinfusion tubing between the blood pump and the return cannula in thevein in the patient's arm. The return bloodline 604 is flashing.

FIGS. 9 and 10 show another two sample screens with the pictogram.Pictogram 701 shows a system that has detected a disconnectedultrafiltrate pressure sensor. The lead wire 702 that connects thepressure sensor 706 in the disposable cartridge to the connector 705 onthe console is the pictogram element flashing. Pictogram 703 shows thefrontal view of the system with the blood withdrawal line 704 flashing.The error detected by the system is a disconnection in the bloodwithdrawal line between the patient and the blood pump 707.

FIGS. 11 and 12 show a pictogram 801 of the system that detected adisconnection in the ultrafiltrate withdrawal line 802. A side view ofthe pump console is shown and the ultrafiltrate line is highlighted.Pictograph 803 of the system shows that there is a detected a jammedrotor of the blood pump 804. The pump element of the pictogram ishighlighted and flushing.

FIGS. 13 and 14 show a pictogram 901 of the system that has detected anocclusion in the blood withdrawal segment of the circuit. The withdrawaltubing 902 is flashing to attract the user's attention. The pictogram903 shows the ultrafiltrate removal bag. The system has detected thatthe amount of fluid added to the bag does not correspond to the usersetting, such as will occur when the bag is filled and needsreplacement. The amount of fluid is detected by continuously weighingthe ultrafiltrate collection bag. The fluid level 904 in the bag isflashing on the pictogram to attach the user's eye.

FIGS. 15 and 16 show a pictogram 906, of the system with an electricallydisconnected or malfunctioning blood withdrawal pressure sensor. Theelectric disconnection of the sensor can be detected by the system byreading an abnormal voltage output from the sensor. The sensor connectorand wire element 905 of the pictogram 906 is flashing. The pictogram 907shows the system that detected occlusion in the ultrafiltrate removalline between the hemofilter and the ultrafiltrate pump. Theultrafiltrate segment of tubing 908 in the fluid path is flashing.

FIG. 17 illustrates the electrical architecture of the ultrafiltrationcontroller system 200 (Part of 100 in FIG. 1), showing the varioussignal inputs and actuator outputs to the controller. The user-operatorinputs the desired ultrafiltrate extraction rate into the controller bypressing buttons on a membrane interface keypad 125 on the controller.Other user settings may include the maximum flow rate of blood throughthe system, maximum time for running the circuit to filter the blood andthe maximum ultrafiltrate rate. The settings input by the user arestored in a memory and read and displayed by the controller CPU 205(central processing unit, e.g., microprocessor or micro-controller) onthe LCD screen 127. CPU 205 is equipped with memory system 209 wheresoftware code and data are stored.

The controller CPU regulates the pump speeds by commanding a motorcontroller 202 to set the rotational speed of the blood pump 122 to acertain speed specified by the controller CPU. Similarly, the motorcontroller adjusts the speed of the ultrafiltrate pump 126 in responseto commands from the controller CPU and to provide a particular filtrateflow velocity specified by the controller CPU.

Feedback signals from the withdrawal pressure sensor 112, ultrafiltratepressure sensor 114 and blood return pressure sensor 113 are convertedfrom analog voltage levels to digital signals in an A/D converter 216.The digital pressure signals are provided to the controller CPU asfeedback signals and compared to the intended pressure levels determinedby the CPU. This allows the CPU 205 software to detect disconnectionsand occlusions in the fluid path. In addition, the digital pressuresignals may be read by the Safety system Processor 214. This ensuresredundancy of critical safety monitoring functions of the system.

The motor controller 202 controls the velocity, rotational speed of theblood and filtrate pump motors 203, 204. Encoders 206 and 207 mounted tothe rotational shaft of each of the motors as feedback providequadrature signals (e.g., a pair of identical cyclical digital signals,but 900 out-of-phase with one another). These signal pairs are fed to aquadrature counter within the motor controller 202 to give bothdirection and position. The direction is determined by the signal leadof the quadrature signals. The position of the motor is determined bythe accumulation of pulse edges. Actual motor velocity is computed bythe motor controller as the rate of change of position. The controllercalculates a position trajectory that dictates where the motor must beat a given time and the difference between the actual position and thedesired position is used as feedback for the motor controller. The motorcontroller then modulates the percentage of the on time of the PWMsignal sent to the one-half 218 bridge circuit to minimize the error. Aseparate quadrature counter is independently read by the Controller CPUto ensure that the Motor Controller is correctly controlling thevelocity of the motor. This is achieved by differentiating the change inposition of the motor over time. Additional source of information aboutthe performance of the fluid path of the system are the digitized systemvoltages and currents 210. The CPU 205 can determine such events as ajammed pump 122 or 126 or an occluded filter 111 by continuouslymonitoring feedback from encoders 206 and 207 and current consumed by DCmotors 203 and 204.

The CPU 205 monitors each of the critical signals, including signalindicative of blood leaks 155, pressures in blood circuit 112, 113 114,weight of filtrate bag 208, motor currents, air in bloodline detector154 and motor speed/position. The CPU has stored in its memory safetyand alarm levels for various operating conditions of the ultrafiltratesystem. By comparing these allowable preset levels to the real-timeoperating signals, the Safety system Processor 214 can determine whethera safety alarm should be issued, and has the ability to independentlystop both motors and reset the motor controller 202 and controller CPU205 if necessary. It can also pinpoint the location of the alarm sourcealong the fluid path of the machine.

FIG. 18 shows the implementation of the electronics that enables theapparatus to detect if the plug-in disposable pressure sensors 112, 113and 114 are electrically connected to the Console 100. Quick connectors218, 219 and 220 are a part of the single use blood circuit 109 (SeeFIG. 1). They plug into receptacles that are electrically connected tothe internal electronics of the apparatus. The pressure transducerconnection scheme uses pull-up resistors 226, 227 and 228 to enable theCentral Processor Unit (CPU) 205 to detect the connection of thepressure transducers. This ability is used to aid the user introubleshooting and setup of the apparatus. The pull up resistors 226,227 and 228 in the preferred embodiment are 10 MOhm. The electricresistance of pressure sensors 113, 114 and 115 is approximately 3 KOhm.It is essential that the resistance of pull-up resistors issubstantially higher than the resistance of the sensors. This way whenthe sensors are connected the voltage source 233 does not contribute tothe pressure reading by the CPU 205. By displaying a pictogram on theLCD screen the apparatus can request the user to connect a particularpressure transducer and switch to the next setup instruction when theconnection has been performed.

When the disposable pressure transducers 112, 113 and 114 are notconnected, the amplifier 221 is saturated with the 5 Volt DC voltagesources 233 and the CPU 205 reads 4,096 digital counts generated by the12-bit ADC 216, which corresponds to greater than 600 mmHg pressure.This pressure is much higher than what can be normally expected by themachine. Therefore, when the CPU detects such high-pressure level, itcan inform the user that a particular pressure sensor is unplugged ordisconnected. By instructing the user to connect a specific pressuretransducer 112, 113 or 114 the CPU 205 can detect when the transducer isconnected by continuously measuring pressure, and waiting for thepressure to fall within an expected window.

Although the present invention has been described in terms of aparticular embodiment, it is not intended that the invention be limitedto that embodiment. Modifications of the disclosed embodiment within thespirit of the invention will be apparent to those skilled in the art.The scope of the present invention is defined by the claims that follow.

1. A system for detecting an electrical sensor comprising: a sensorsignal processing circuit further comprising an input port to receive aconnector, wherein the input port is connected to a resistor and theresistor is connected to a predetermined voltage level; a sensor circuitfurther comprising a connector adapted to connect to the input port ofthe sensor signal processing circuit, wherein the sensor circuit has aresistance substantially less than the resistor, and wherein the sensorsignal processing circuit detects an unconnected sensor based on avoltage applied by the resistor to the sensor signal processing circuit.2. The system of claim 1 wherein the resistor is a pull-up resistor andthe predetermined voltage is a voltage supply.
 3. The system of claim 1wherein the resistor is a pull-up resistor and the predetermined voltageis five (5) volts.
 4. The system of claim 1 wherein the resistance ofthe resistor is at least three times the resistance of the sensorcircuit.
 5. The system of claim 1 wherein the resistance of the resistoris at least one Meg Ohm and the resistance of the sensor circuit is nogreater than three Kilo Ohm.
 6. The system of claim 1 wherein theresistor comprises a plurality of parallel resistors and each of theresistors is connected to different input port.
 7. The system of claim 1wherein the sensor circuit is on an extracorporeal blood circuit and thesensor signal processing circuit is included in a pump controller.
 8. Asystem for detecting an electrical sensor circuit comprising: a sensorsignal processing circuit further comprising an input port, a signalline connecting the input port to the processing circuit, a pull-upresistor connected between the input port and a predetermined voltage,wherein said signal line is connected to an amplifier; a sensor circuitcomprising a connector adapted to connect to the connector, wherein thesensor circuit has a resistance substantially less than the pull-upresistor, and wherein the sensor signal processing circuit detects anunconnected sensor based on the amplification of the voltage beingoutside a preset limit.
 9. The system of claim 8 wherein thepredetermined voltage is a voltage supply.
 10. The system of claim 8wherein the predetermined voltage is five (5) volts.
 11. The system ofclaim 8 wherein the resistance of the pull-up resistor is at least threetimes the resistance of the sensor circuit.
 12. The system of claim 8wherein the resistance of the pull-up resistor is at least one Meg Ohmand the resistance of the sensor circuit is no greater than three KiloOhm.
 13. The system of claim 8 wherein the pull-up resistor comprises aplurality of parallel pull-up resistors and each of the resistors isconnected to different input port.
 14. The system of claim 8 wherein thesensor circuit is on an extracorporeal blood circuit and the sensorsignal processing circuit is included in a pump controller.
 15. A systemfor detecting an electrical sensor circuit comprising: a sensor signalprocessing circuit further comprising an input to receive a connector toan output of the sensor circuit, a signal line connecting the input tothe processing circuit, and a resistor connected between a signal lineand a predetermined voltage; the sensor circuit comprising a connectoradapted to connect to the input, wherein the sensor circuit has aresistance substantially less than the resistor, and wherein the sensorsignal processing circuit detects an unconnected sensor circuit based onthe voltage being outside a predetermined limit.
 16. The system of claim15 wherein the resistor is a pull-up resistor and the predeterminedvoltage is a voltage supply.
 17. The system of claim 15 wherein theresistor is a pull-up resistor and the predetermined voltage is five (5)volts.
 18. The system of claim 15 wherein the resistance of the resistoris at least three times the resistance of the sensor circuit.
 19. Thesystem of claim 15 wherein the resistance of the resistor is at leastone Meg Ohm and the resistance of the sensor circuit is no greater thanthree Kilo Ohm.
 20. The system of claim 15 wherein the resistorcomprises a plurality of parallel resistors and each of the resistors isconnected to different input port.
 21. The system of claim 15 whereinthe sensor circuit is on an extracorporeal blood circuit and the sensorsignal processing circuit is included in a pump controller.